[Aspiration and hypoxia after extubation]

The period of extubation was observed for the occurrence of aspiration and hypoxia. Two basically different methods of extubation were used. The risk of aspiration, according to the literature and our own investigations (40 cases), can not be totally eliminated in spite of various preventive measures. But hypoxia can be prevented without an increased risk of aspiration by the following method: after oxygenation with 100% oxygen for 3 min, oropharyngeal suction is done with the table tilted in 10 degrees Trendelenburg position (tracheal suction is only done in patients with apparently increased bronchial secretions). Then the lungs are inflated maximally the cuff is deflated, and the endotracheal tube removed at maximal inspiration. After extubation the patient breathes 100% oxygen by mask for another 3 min.